City Girl Tales

PCOS, unicornuate uterus, and motherhood after infertility in the big city

Wednesday, May 31, 2006

Wasting time

I thought that after all the injections and blood draws and cooter-cam rides were over, I might be able to focus and get some work done. But no, at 3dpiui, I am as distracted as ever. Blogging is a blessing and a curse. Blessing: reading blogs gives me something to do all day. Curse: I'm supposed to be, you know, working or something.

Last night I dreamed I got my period. I remember thinking, as I stared at the dream-blood in my dream-panties, wow, trigger on CD9, IUI on CD11, period on CD14, shortest cycle EVER. I also thought, in my dream, well, at least the medication left in my Follistim pen won't go to waste.

In another of my la-la-la-I'm-moving-on-with-my-life gestures, I bought 8 tank tops today (on sale, naturellement). Size small. Very fitted. I think I have a sickness.

Monday, May 29, 2006

A beautiful day for an IUI

A few hours after my last post, I got the symptoms I was looking for--my boobs became unbelievably sore, and still are. No bloating (yet), but all day yesterday things were pretty tender in my whole abdominal area. I could also feel my ovaries--every time I took a step, I felt my right ovary jostling around in there. I'll never wonder exactly where my ovaries are again.

Despite these symptoms, I still wasn't totally convinced I was ovulating, so yesterday morning, before we left for the clinic, I stuck a finger up my cha-cha for old time's sake. Never before has my cervix been so high, soft, and open. Also, I have never had so much EWCM in my life.

This was the first time my husband had produced a specimen at our new clinic, so naturally I was excited to hear what the collection room was like. Our former clinic had sent him to an outside andrology lab for his sperm analysis, where he'd had a nurse walk in on him while he was, uh, working on producing. ("Hey, I guess this place is full-service," he said to the flustered nurse before she speedily backed out of the room.) This lab, located in one of the poshest neighborhoods in Big City, had a vast collection of some of the most "disgusting" (his word, not mine) porn my husband had ever seen--and he's been on the Internet, so he knows whereof he speaks. (I shall not describe it, because I do not want those Google hits.) Apparently the collection room was wall-to-wall porn--literally; the very walls were hung with pornography.

The clinic's collection room was disappointing by contrast. My husband said there were just three magazines and a DVD, none of which he bothered looking at.

After the weeks of buildup, the IUI itself was something of an anticlimax. After telling us the "sample" looked good (23 million sperm post-wash, "moving nicely"), the doctor (not Dr. SF, but a nice doctor I'd had before for monitoring, so that was fine) was in and out of there in under a minute. I barely felt a thing. "That's it?" I said disbelievingly. "That's it!" he replied as he zoomed out the door. "Lie down for five minutes, no strenuous exercise today but otherwise go about your usual activities."

After I remained lying down for ten minutes (I'm an overachiever), we went about our Sunday. We took a walk (slowly, so as to minimize the jostling) through the park, where I was in such a good mood I didn't even say anything hateful under my breath when we found ourselves walking behind an expensive-looking couple with a Bugab0o and a Lou!s Vu!tton diaper bag. We went to brunch, at a restaurant where every couple with a baby and pregnant woman in the city had also apparently decided to go--and I didn't mind a bit. We strolled through a street fair, went to see the new X-M*en movie, had pizza for dinner. And I felt optimistic, for the first time in a very long time. We'll see how long it lasts.

Saturday, May 27, 2006

I. Am. A. Moron.

I am so embarrassed about this that I almost wasn't going to post it, but figured as long as I'm already sharing every microscopic detail of this cycle with you all, I might as well. So, in case you weren't yet convinced that I am the biggest idiot ever to wield a gonadotropin-filled needle, may I present Exhibit B:

Last night I did my trigger injection. Took the Ovidrel box out of the fridge, set myself up with swabs and rubbing alcohol, iced down my belly. I'd also had a glass of wine to take the edge off.

When I took the syringe out of the box, I noticed a fairly large air bubble inside. Despite having had an injection class lasting over an hour, I could not for the life of me remember if they'd said anything about air bubbles (not really an issue with the Follistim pen). (In my defense, we spent about half an hour on Follistim and about 5 minutes on Ovidrel.) Like a good newbie, I had already memorized the patient information insert, which said helpfully, "Inject as directed by your doctor," so I knew there was no help to be had there.

But okay, I could handle this. I pointed the needle upward and tapped the syringe to get the air bubble to rise to the top. Then I gently pressed the plunger to try to get the air bubble out. But only beads of medication came out. Obviously there was some medication trapped between the bubble and the needle. I kept trying--tapping, then pressing--but still, only little droplets came out.

I didn't know what to do. I was afraid I was only pushing out valuable medication, and while I remembered that Follistim cartridges are overfilled, I had no idea if Ovidrel syringes were too. I had my pants open, my belly swabbed, the needle unsheathed. I couldn't just run to the computer to find out what to do. I'm not sure what I was thinking, but I finally just grabbed some flab, stuck the needle in, and pushed the plunger down, v e r y s l o w l y so as not to push a pocket of air into my flesh.

Except that's exactly what I did. All the medication went out of the syringe, then before I could stop, the air pushed into me with a loud "pffft." I stared down in horror for a second, then pulled the needle out. A big drop of bright red blood followed it out (about a nickel-size stain on the alcohol-moistened cotton square).

I panicked. I ran and told my husband what I'd done, then ran to the computer, where I googled various combinations of "subcutaneous injection air embolism." I finally convinced myself that I probably wouldn't die (and I'm not dead yet, so I guess I'm OK), and that the only potential problem, according to Dr Google, might be that I didn't get the full dose of medication. I was worried about the blood, but my husband suggested that maybe the air pushed the blood out, and I only have the tiniest of bruises, so I guess it's fine.

But now, of course, I'm worried about the whole not-getting-the-full-dose thing. Almost 20 hours later, and I don't have any of the side effects most people seem to get from hcG--no bloating, no sore breasts, nothing. Argh! I have to stop second-guessing myself and just try to chill out. What's done is done.

Friday, May 26, 2006

No comment

I just read the following in a description of a book coming out this fall:

"Anna and Mac were the perfect couple until the heartbreak of infertility disrupted their lives. Now all Mac can expect when he comes home from work is a drunken wife and a growing feeling of emptiness."

Thursday, May 25, 2006

Holy crap! *UPDATED*

Today, CD8, after 5 days of stims, I had two 16 mm follicles on the right side, with a third not far behind. Nothing worth measuring on the left side, but we don't care about the left ovary anyway. Go right ovary!

Dr. Silver Fox did my ultrasound this morning. Depending on how my bloodwork comes back, he says he'll most likely have me coast tonight (no meds), trigger tomorrow night, IUI Sunday morning. I think the expression on my face was roughly: "....gah?" "This was a fast cycle for you!" he said cheerfully. No kidding! My husband had just been asking me last night when his, er, services would be needed, and I'd told him, oh, I'm only on day 5 of meds, probably another week. So to say that hearing I'll be triggering on day 9 was a surprise is something of an understatement. When Dr. SF said, "And two weeks from tomorrow, you'll know if you're pregnant," I almost teared up a little.

Of course, hearing that there were three follicles, I had to ask: with three, what are the chances of multiples? Dr. SF reiterated that I'm still more likely to not get pregnant at all, but if I do get pregnant, there's a 20 percent chance of multiples. And let's remember, multiples + unicornuate uterus = bad idea.

I'd had a long talk with my husband earlier this week about selective reduction, and we had another one this morning after my appointment. As it turns out, his objection to reduction is not the expected Catholic-school boy pro-lifer qualm, but rather simply the idea of having to decide which of your potential offspring stays and which goes. "How do you make a decision like that?" he said to me. The procedure itself is not so much an issue, apparently. (I am not in love with the idea of selective reduction, but I wouldn't have a problem doing it if my doctors tell me it's the best thing to do for my own safety and the health of my pregnancy.)

So this morning I told him what Dr. SF said, and that I figured the overall chance of getting pregnant with multiples this cycle was probably around 10 percent. (I just found this, which seems to indicate that it might be even less.) But no matter how low the odds, one thing blogging has taught me is that there is always a real person in that low-odds percentage.

I said that the possibility exists that we might need to make some hard decisions down the road, and if he was not okay with that possibility he needed to tell me. I would be 100 percent okay with canceling the cycle if he didn't think he could handle the ramifications, and we would just need to go to IVF.

He said, "Let's go ahead."

So here we go. I'm excited! Terrified, but excited.

This entry turned out to be a lot longer than I intended...but I will update later today when the nurse calls with results.

*UPDATE*E2=1074. I think that's OK. Is that OK? Maybe a little too high? But I'm coasting tonight, so it's probably fine. Doctor isn't concerned, so I'm going to try not to worry about it.

And IUI will definitely be Sunday. At long last, after seven months of treatment, I FINALLY have a cycle not get canceled. Woohoo!

Tuesday, May 23, 2006

I love the smell of ultrasound gel in the morning

Thanks for all the supportive comments on my wimpy injector post.Sube said it best, I think: "I cry every time, not from the pain, but simply because I have to do it at all. That's the part that sucks." Standing there, with that needle pointing at my belly, is a (literally) painful reminder of just how my body has failed, in a way that popping pills or, frankly, even riding the dildocam is not. But it does seem to be getting easier--last night, I still got anxious in the half-hour before I did it, but the injection itself went off without a hitch.

After months of hibernation, my right ovary has finally woken up, just in time for spring. And with a vengeance: At this morning's ultrasound, the doctor counted six (smallish) follicles on the right side, and about the same on the left (didn't even bother to count). A nurse just left me a message--no surprise, I'm to reduce my dose to 75IU and come back Thursday. I hope one or two of those suckers will break away from the pack.

Monday, May 22, 2006

Stick it

My friends, I am here to call bullshit on this whole injection business.

Reading IF blogs and living in a virtual world where everyone is shooting up something (some of you brave ladies four or five times a day) normalizes it, to the point where even I, the biggest needle wimp in the universe, was thinking, "It's just one little needle, what's the big deal?" And it's a good thing, too--if we weren't able to make it all seem normal and acceptable, how would we ever get through the day? REs, too, and their nurses, are so used to the various processes of fertility treatment that they see self-injection as no big deal, and communicate as much to us, the patients.

But I have to say that there is nothing normal about jabbing a needle into your own soft flesh every day before bed. And as much as the rational part of my mind tries to be cool with it, my needle-phobic id is screaming bloody murder.

Again, I am probably the biggest needle wimp you will ever encounter. When I have blood drawn--hell, even when I get a flu shot--I have to look away, close my eyes, and practice deep breathing exercises to get through it. Saturday, when I was having blood drawn for my CD3 bloodwork, I winced as the needle went into my arm, and the phlebotomist fell all over herself apologizing. I had to tell her that actually, she did a lovely job (and she did--not a mark on me), but that I am such a colossal baby that even the tiniest pinch makes me cringe.

So I was a little apprehensive about doing my very first Follistim injection Saturday night, but I tried to bluff my way through it with a lot of knowledge (obsessively rereading the patient insert) and a little denial. Piece of cake, I told myself. Diabetics do this all the time! I said. I can be just as tough as those other women, I insisted.

But I noticed my hands were trembling a little as I prepared the pen, swabbed a swath of my belly, and dialed up the dosage. Just take it slow, I told myself. Everyone says you barely even feel it going in.

Well, when the tip of the needle hit my skin, I felt that motherfucker. And some primitive reflex caused my hand to jerk back, pulling the needle out. So I had to go in again, plunging it all the way in as directed, pressing down the incredibly slow plunger. I think in my panic I was squeezing my flesh a little too hard, because when I finally slid the needle out, a little bead of medication formed on the surface of my skin, tinged with blood.

When it was done, I felt like crying. Not because it hurt that much--really, it was just a pinch--but because I felt like such a loser for having so much trouble with it. It really wasn't so hard or painful, so why couldn't I just suck it up like the thousands of other women doing the same thing? And how would I get through the next 9 (at least) days?

I am happy to report that my second injection, last night, went much better. I iced the area beforehand, which helped. And it also helped that my husband was watching me do it. When I showed him the needle, at first he said, "Oh, that's nothing." I think he was trying to make me feel better. Wanting to be brave in front of him, I gritted my teeth and shoved it in--no poke-and-hunt this time. When I was finished, he said, "Wow. I can't believe you did that. I could never have done that."

Saturday, May 20, 2006

CD3 fun and games

The only good thing about having to get up at the crack of dawn on a SATURDAY to make it to early morning monitoring hours is that I didn't have to put on makeup, do my hair, or attempt to piece together a decent work outfit while half-blind with sleep deprivation, as I normally must on weekdays. (Not only to I need to get up two hours earlier to make it to the clinic early enough to get out of there and get to work...whenever I have to get up early, I'm so anxious about it I can't sleep the night before.) I did, however, give the ol' cooter a quick scrub--it being CD3 and all, I thought that was only common courtesy. Ultrasound and bloodwork all OK, so I'm cleared to start shooting up tonight.

On my way to the pharmacy this afternoon to pick up my meds, I stopped off at Large Generic American Chain Store and bought a new pair of jeans. Tight jeans. These jeans, actually. In a totally pregnancy-incompatible size, shall we say.

I know it might seem crazy, considering I'm starting a new treatment cycle and I very well could be pregnant in a month. In fact, the Follistim bloat alone will probably make this seem like a very dumb purchase very quickly. But it's self protection, really. I spent so long putting things off because I might get pregnant--buying a cute outfit, planning a vacation, etc. etc. And the months rolled by, and I didn't get pregnant, and I didn't enjoy myself either.

So fuck it. I'm not putting my life on hold. (And the jeans were on sale, AND they make my ass look great.)

Thursday, May 18, 2006

Sigh.

Am a little tipsy right now, so please bear with my vague incoherence.

This evening I went out for drinks with two of my coworkers. One of them was one of the pregnant ones (the first one); neither of them knows of my IF problems, of course, because no one at work knows. (A nurse from my clinic called me with CD3 instructions while I was giving some direction to my assistant; I had a very cryptic conversation--"Same time?" "OK, see you then!"--while my little dewy-eyed 22-year-old assistant waited for me to finish.)

Now, I have been VERY GOOD lately about the whole pregnant coworker thing. I had privately resolved to try not to feel as if everyone else's pregnancies were personal slaps in the face, as hard as that is, so in addition to my self-prescribed desensitization therapy, I have been chatting with my coworker/friend (we are pretty friendly; are the same age and married the same length of time, have lots in common and have talked a lot about personal stuff) about her pregnancy, being supportive, debating the relative safety of soft cheeses, that sort of thing. Really, VERY good. And the optimism I've been feeling about starting injectibles--it's a weird sort of excitement that grips us when we start a new phase of treatment, isn't it? This is the one that will work!--has helped a lot, too.

For the most part, I had a great time tonight. But there was one very hard moment. The pregnant one--let's call her B.--was talking about how she has a friend who has been struggling with infertility, and it was hard for her to know how to break the news of her pregnancy to her IF friend (remember, she got pregnant the VERY FIRST TIME she had sex without birth control), and how she wasn't sure how much to talk about her pregnancy for fear of hurting her friend, etc. So far, so good. B. is a very sensitive, caring person, and I knew she was very concerned and tender-hearted toward her friend--she's mentioned her before. But THEN--B. said that her friend had one friend who had gotten pregnant really easily, who had 2 kids already, and she knew that had been hard for her--and that she had another friend who had had trouble, eventually conceived through IVF, and once that baby was born, conceived her second, without ART, very soon after--"because the pressure was finally taken off."

Well. You can imagine my internal reaction. But before I had a chance to formulate my response, my other coworker/friend (we'll call her N.) broke in, all indignant, saying, "No, it wasn't because the pressure was finally taken off, it was just the luck of the draw," and went on to rail against the whole idea of "just relax," that saying things like that just puts even more pressure on women, etc. She said all the right things! (I don't think N. has had IF issues herself--she was married for a short time, is now divorced, not seeing anyone--but is certainly of an age where she probably has friends who have.)

I was feeling all warm and fuzzy toward N., when she went on to say something to the effect of, a lot of the people who others claim got pregnant because they "just relaxed", it had nothing to do with them relaxing, it would have happened one way or another. "I have nothing against IVF," she said, "but I think a lot of women who do it might have gotten pregnant anyway if they'd just had the patience to wait two or three years."

Well then. I really couldn't react to that without giving the whole show away ("Yeah, well, my husband and I could shag like rabbits for the next ten years, but what with the only ovulating four or five times a year plus having one fallopian tube, I'd say the chances are pretty slim"). So I turned away and became very engrossed in my glass of champagne for a few minutes, until they got bored of the topic and moved on.

Here's the thing. I don't want to confide in either of them about my fertility issues. I don't think they would understand, I don't think it's politically smart right now for me to be talking about my fertility plans to coworkers, and I have the support I need from other friends and from my friends inside the computer. But I have to admit, there is a part of me that wanted them to notice that I was having a very emotional reaction to this conversation, to wonder why I was turning away with tears in my eyes, to think twice the next time they said things like that in front of me.

But they didn't notice. And they won't think twice next time, or the time after that.

Tuesday, May 16, 2006

As usual, waiting

One of the greatest ironies of infertility is that, at a time when I have never felt more betrayed by and detached from my body, I have also never been more intimately attuned to the rhythms and physicality of my body.

Part of that is simply from, as I've gotten older, taking a lot better care of myself than I did in my twenties--eating better, exercising, doing things like yoga that have helped me tune into the subtle shifts in energy and strength and flexibility that happen every day.

But of course, as any reproductively challenged woman knows, most of it comes from the demands of IF itself, the constant monitoring, the obsessive poking and prodding and measuring that we all do to try to maximize our chances of getting and staying pregnant. For me, it started the moment I went off the pill. I always knew getting pregnant might prove tricky for me, so I began monitoring BBTs and cervical mucus immediately.

Now, almost two years later, I've gone from a girl who got squicked out at the thought of inserting an applicator-less OB tampon (what if I got blood on my finger?!?) to someone who has played with and examined nearly every fluid that has exited my body--and gone spelunking for fluids that are too stubborn to make the trip. I know the tender feeling of my cervix just before ovulation. I know that the week after my period, my skin will resemble a porcelain doll's, and that two days after I ovulate, it will erupt in an angry, molten, chin-to-forehead mess. I know that two days before my period, eleven days after ovulating, I'll feel sluggish, my boobs will hurt, I'll feel bloated, and I'll start spotting. I know that one hour before the flow starts, I'll start cramping.

Based on all other clues (except BBT, which I dispensed with this cycle), I'm virtually certain I ovulated two weeks ago today. And yet, the one time I am eager for my period to arrive--I'm anxious to get this injectibles cycle started--there is nary a spot in sight. I am definitely not pregnant--let's just say there was no chance for sperm to meet egg--so what the hell is up? Sigh. Maybe some contorting in yoga class tonight will wring it out of me.

Thursday, May 11, 2006

Only connect

I had my injection class this morning. For all that I was bitching about it being inconvenient and ridiculously long, it ended up being pretty useful. It only took an hour, not the hour and a half threatened, thank goodness. The very perky nurse went over the clinic's protocol for IUI with injectibles (other than the additional monitoring, it differs in other minor ways from Clomid IUI--not that I've ever managed to have one of those) and gave us lots of handouts on the meds we're using (Follistim and Ovidrel for most) and their side effects.

A couple of the women--there were six of us total, two of whom brought their husbands--were freaking out at the description of OHSS, which of course I already knew all about from my friends inside the computer and Dr. Google. I don't understand--I'm sure these people can afford computers, how do they NOT jump on the Internet and get every scrap of information possible? Ditto for one woman's shock that we would have to have US and bloods every other day--it's all there on the Internets, honey. Reminded me of Beth wanting to pass out a blogroll to everyone in her IVF class. Finally, we got to practice loading up the Follistim pen and injecting a very battered-looking dummy.

I suppose I could have gotten all the information just as easily if I'd just had 10 minutes with the nurse. And I definitely didn't appreciate finding out that my insurance doesn't cover the class and I had to fork over $150 for it. But other than the information, it was actually nice to just be sitting in a room with a bunch of other infertile women. As much as I love blogland and my friends inside the computer (and you know I love you, baby--you’ll always be my number one), I do miss having that human, face-to-face connection with other people who understand.

Like, when the nurse was going over timing (Ovidrel injection between 10-11 pm, intercourse that night, abstain the next day, IUI the day after), one husband asked about intercouse after the IUI. The nurse said, "Well, it can't hurt, so you can certainly have intercourse if you want to." Another woman said, "I don’t think any of us will want to!" and we all nodded and laughed. The husband who asked the question joked, "Yeah, I’ve never felt so unattractive in my life." Or when the nurse was talking about the 2ww, and one woman said, “Oh, that’s the worst time,” and we all gave little sighs.

I try to grasp at real-life moments of connection like this wherever possible. Last Thursday I had dinner with a good friend who was eager to get the update on everything we're going through. She's not actively TTC (off the pill, waiting to see what happens, noting her very irregular cycles), but she asked intelligent questions and totally got everything I was saying from an emotional standpoint, too.

Then the next night, I had dinner with another friend, who wanted to pick my brain about switching careers to my field. One glass of wine thing led to another and I found myself telling her that we were trying to get pregnant, that it wasn't going well, etc. And immediately regretted it. Not only was everything I was saying completely incomprehensible to her emotionally, she asked the most annoyingly stupid questions. Like "What’s Clomid?" and--I kid you not--"What’s IVF?" To her credit, she did figure out that last one on her own ("Oh, wait...in...vitro...fertilization?") but I was flabbergasted. Honestly, what educated 30-something woman has never ever heard of Clomid?!? Sigh.

Thursday, May 04, 2006

Killing time

For the first time in a very long time, there is really zero chance I could be pregnant this cycle. We did not manage to have sex over the weekend, as urged by Dr. SF. My husband's sister was staying with us, and given the size of a Big City apartment, the presence of blood relatives is definitely a damper on feeling amorous. And though I suppose I could have insisted that we give it a whirl, I really didn't feel like having silent, "don't let the bed squeak!", Forced Death March (tm someone, I can't remember who--maybe Kath?) sex when there's only, like, a 0.5% chance it would work anyway.

It's oddly relaxing, knowing there's no way in hell I could be knocked up. No need to obsess over symptoms, or take my temperature, or anything. Just wait for my period to arrive--due on or around Mother's Day! Fun!

My husband went out of town Sunday morning, and will be returning this weekend. I think this is the longest we've been apart since we've been married. Here's a little of how I've amused myself during this week of single living:

• Playing the "ovulation or constipation?" guessing game, in response to some cramping a little to the left and a couple inches below my belly button, a few days ago. (I've never experienced ovulation pain before, and I must admit that even after two years of IF, I have only a vague idea of where exactly my ovaries are located within my abdomen.)

• Enjoying various non-pregnant treats, including but not limited to: allergy medication, self-tanner, raw milk cheese, at-home facial peels, margaritas, ordering bikinis online (though it now occurs to me that the latter may not be such a good idea, given that my belly will likely be bruised from injections all summer long...hmmm...)

• Reading back through posts from women with UU on the MA Yahoo support group (link on my homepage sidebar). Some of them have successfully gotten pregnant with singletons from injectibles/IUI, so that made me feel a little less like I'm wasting my time. At the very least, I think, doing Follistim this cycle will be practice for doing IVF--a baby step.

• Cultivating Zen acceptance upon hearing that another one of my coworkers is pregnant. Yes, another one--that makes two coworkers and one friend in two weeks, and a grand total of 24 friends/relatives/coworkers of mine giving birth or gestating since last August. You know how sometimes, fertile people get really uncomfortable talking about or hearing about infertility, like it's catching or something? They shouldn't be worried--clearly it's just the opposite. Really, we should be hiring ourselves out as fertility charms. I can see the Cra!gsl!st post now:

Want to get pregnant? Be my friend! I will attract all the infertility energy within a ten-mile radius, leaving nothing but babydust and sticky vibes for you! You will be pregnant in three months or less or your money back! Rates start at $1000/month (hey, how else am I going to pay for IVF?). Extra charges for squealing at your pregnancy announcement, listening to you talk about how it "only took once!", or shopping for maternity clothes.

Seriously, girls. Think about it. This could be a big money maker for us!

About Me

Like the tagline says...I have PCOS. I have a unicornuate uterus. I live in Big City, USA. We started TTC in June 2004 (I was 30; we'd been married 2 years), and got lucky with an IUI/injectibles cycle in May/June 2006. After a tough pregnancy and four months of bedrest, I gave birth to my Bat Girl in Feb. 2007. We started TTC#2 in 2009 and after many, many IUIs I got pregnant in November 2011 on our first IVF cycle. Baby Brother was born in July 2012, making our family complete.